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NBS - 2015 Agreement
AGREEMENT FOR SERVICES (For contracts of $5,000 or less - CONSULTANT) This AGREEMENT made this ` day of 20 -, between: CITY: City of Gilroy, having a principal place of business at 7351 Rosanna Street, Gilroy, California and CONSULTANT: NBS, having a principal place of business at 32605 Temecula Parkway, Ste 100, Temecula, CA 92592. ARTICLE 1. TERM OF AGREEMENT This Agreement will become effective on April 1, 2015 and will continue in effect through completion of project unless terminated in accordance with the provisions of Article 7 of this Agreement. ARTICLE 2. INDEPENDENT CONTRACTOR STATUS It is the express intention of the parties that CONSULTANT is an independent contractor and not an employee, agent, joint venturer or partner of CITY. Nothing in this Agreement shall be interpreted or construed as creating or establishing the relationship of employer and employee between CITY and CONSULTANT or any employee or agent of CONSULTANT. Both parties acknowledge that CONSULTANT is not an employee for state or federal tax purposes. CONSULTANT shall not be entitled to any of the rights or benefits afforded to CITY'S employees, including, without limitation, disability or unemployment insurance, workers' compensation, medical insurance, sick leave, retirement benefits or any other employment benefits. CONSULTANT shall retain the right to perform services for others during the term of this Agreement. ARTICLE 3. SERVICES TO BE PERFORMED BY CONSULTANT Specific Services CONSULTANT agrees to: Perform the services as outlined in Exhibit "A" within the time periods described therein. Method of Performing Services CONSULTANT shall determine the method, details and means of performing the above - described services. CITY shall have no right to, and. shall not, control the manner or determine the method of accomplishing CONSULTANT'S services. -1- aa61- 9718- 0697vl i Anndmrna� Employment of Assistants CONSULTANT may, at the CONSULTANT'S own expense, employ such assistants as CONSULTANT deems necessary to perform the services required of CONSULTANT by this Agreement, subject to the prohibition against assignment and subcontracting contained in Article 5 below. CITY may not control, direct, or supervise CONSULTANT'S assistants in the performance of those services. CONSULTANT assumes full and sole responsibility for the payment of all compensation and expenses of these assistants and for all state and federal income tax, unemployment insurance, Social Security, disability insurance and other applicable withholding. Place of Work CONSULTANT shall perform the services required by this Agreement at any place or location and at such times as CONSULTANT shall determine is necessary to properly and timely perform CONSULTANT'S services. ARTICLE 4. COMPENSATION In consideration for the services to be performed by CONSULTANT, CITY agrees to pay CONSULTANT as provided for in Exhibit `B ", "Payment Schedule ". Invoices CONSULTANT shall submit invoices for all services rendered. Payment Payment shall be due within thirty (30) days after receipt of invoice describing the work performed during the preceding period. If CITY objects to all or any portion of any invoice, CITY shall notify CONSULTANT of the objection within thirty (30) days from receipt of the invoice, give reasons for the objection, and pay that portion of the invoice not in dispute. It shall not constitute a default or breach of this Agreement for CITY not to pay any invoiced amounts to which it has objected until the objection has been resolved by mutual agreement of the parties. Expenses CONSULTANT shall be responsible for all costs and expenses incident to the performance of services for CITY, including but not limited to, all costs of equipment used or provided by CONSULTANT, all fees, fines, licenses, bonds or taxes required of or imposed against CONSULTANT and all other of CONSULTANT'S costs of doing business. CITY shall not be responsible for any expenses incurred by CONSULTANT in performing services for CITY. -2- 4851- 9718 -06970 I Ar.1nd7nFmi ARTICLE 5. OBLIGATIONS OF CONSULTANT Tools and Instrumentalities CONSULTANT shall supply all tools and instrumentalities required to perform the services under this Agreement at its sole cost and expense. CONSULTANT is not required to purchase or rent any tools, equipment or services from CITY. Licenses CONSULTANT shall possess a State of California Contractor's license in the appropriate category for performing services under this Agreement. CONSULTANT shall obtain a City of Gilroy Business License. Workers' Compensation CONSULTANT agrees to provides workers' compensation insurance for CONSULTANT'S employees and agents and agrees to hold harmless, defend with counsel acceptable to CITY and indemnify CITY, its officers, representatives, agents and employees from and against any and all claims, suits, damages, costs, fees, demands, causes of action, losses, liabilities and expenses, including without limitation attorneys' fees, arising out of any injury, disability, or death of any of CONSULTANT'S employees. Indemnification of Liability, Duty to Defend A. As to professional liability, to the fullest extent permitted by law, CONSULTANT shall defend, through counsel approved by CITY (which approval shall not be unreasonably withheld), indemnify and hold harmless CITY, its officers, representatives, agents and employees against any and all suits, damages, costs, fees, claims, demands, causes of action, losses, liabilities and expenses, including without limitation attorneys' fees, to the extent arising or resulting directly or indirectly from any willful or negligent acts, errors or omissions of CONSULTANT or CONSULTANT'S assistants, employees or agents, including all claims relating to the injury or death of any person or damage to any property. B. As to other liability, to the fullest extent permitted by law, CONSULTANT shall defend, through counsel approved by CITY (which approval shall not be unreasonably withheld), indemnify and hold harmless CITY, its officers, representatives, agents and employees against any and all suits, damages, costs, fees, claims, demands, causes of action, losses, liabilities and expenses, including without limitation attorneys' fees, arising or resulting directly or indirectly from any act or omission of CONSULTANT or CONSULTANT'S assistants, employees or agents, including all claims relating to the injury or death of any person or damage to any property. Insurance -3- 4851- 9718- 0697v1 In addition to any other obligations under this Agreement, CONSULTANT shall, at no cost to CITY, obtain and maintain throughout the term of this Agreement: (a) Commercial Liability Insurance on a per occurrence basis, including coverage for owned and non -owned automobiles, with a minimum combined single limit coverage of $1,000,000 per occurrence for all damages due to bodily injury, sickness or disease, or death to any person, and damage to property, including the loss of use thereof; and (b) Professional Liability Insurance (Errors & Omissions) with a minimum coverage of $1,000,000 per occurrence or claim, and $2,000,000 aggregate; provided however, Professional Liability Insurance written on a claims made basis must comply with the requirements set forth below. Professional Liability Insurance written on a claims made basis (including without limitation the initial policy obtained and all subsequent policies purchased as renewals or replacements) must show the retroactive date, and the retroactive date must be before the earlier of the effective date of the contract or the beginning of the contract work. Claims made Professional Liability Insuranc {must be maintained, and �eArs written evidence of insurance must be provided, for at least after the completion of the contract work. If claims made coverage is canceled or non - renewed, and not replaced with another claims -made policy form with a retroactive date prior to the earlier of the effective date N of the contract or the beginning of the contract work, CONSUL T ust purchase so called "extended "tail" reporting" or coverage for a minimum oflaAs after completion of ti work, which must also show a retroactive date that is before the earlier of the effective date of j the contract or the beginning of the contract work. As a condition precedent to CITY'S obligations under this Agreement, CONSULTANT shall furnish written evidence of such coverage (naming CITY, its officers and employees as additional insureds on the Comprehensive Liability insurance policy referred to in (a) immediately above via a specific endorsement) and requiring thirty (30) days written notice of policy lapse or cancellation, or of a material change in policy terms. Assignment Notwithstanding any other provision of this Agreement, neither this Agreement nor any duties or obligations of CONSULTANT under this Agreement may be assigned or subcontracted by CONSULTANT without the prior written consent of CITY, which CITY may withhold in its sole and absolute discretion. State and Federal Taxes As CONSULTANT is not CITY'S employee, CONSULTANT shall be responsible for paying all required state and federal taxes. Without limiting the foregoing, CONSULTANT acknowledges and agrees that: *CITY will not withhold FICA (Social Security) from CONSULTANT'S payments; *CITY will not make state or federal unemployment insurance contributions on CONSULTANT'S behalf, *CITY will not withhold state or federal income tax from payment to CONSULTANT; *CITY will not make disability insurance contributions on behalf of CONSULTANT; *CITY will not obtain workers' compensation insurance on behalf of CONSULTANT. -4- 4851- 9718- 0697v1 ARTICLE 6. OBLIGATIONS OF CITY Cooperation of City CITY agrees to respond to all reasonable requests of CONSULTANT and provide access, at reasonable times following receipt by CITY of reasonable notice, to all documents reasonably necessary to the performance of CONSULTANT'S duties under this Agreement. Assignment CITY may assign this Agreement or any duties or obligations thereunder to a successor governmental entity without the consent of CONSULTANT. Such assignment shall not release CONSULTANT from any of CONSULTANT'S duties or obligations under this Agreement. events: ARTICLE 7. TERMINATION OF AGREEMENT Termination on Occurrence of Stated Events This Agreement shall terminate automatically on the occurrence of any of the following 1. Bankruptcy or insolvency of either party; 2. Sale of the business of either party; 3. Death of either party. Termination by City for Default of Consultant Should CONSULTANT default in the performance of this Agreement or materially breach any of its provisions, CITY, at CITY'S option, may terminate this Agreement by giving written notification to CONSULTANT. For the purposes of this section, material breach of this Agreement shall include, but not be limited to the following: 1. Not performing any of its services professionally and/or timely. 2. CONSULTANT'S breach of any of its representations, warranties or covenants contained in this Agreement. CONSULTANT shall be entitled to payment only for work satisfactorily completed through the date of the termination notice, as reasonably determined by CITY, provided that such payment shall not exceed the amounts set forth in this Agreement for the tasks described on Exhibit `B" which have been fully, competently and timely rendered by CONSULTANT. Notwithstanding the foregoing, if CITY terminates this Agreement due to CONSULTANT'S default in the performance of this Agreement or material breach by CONSULTANT of any of its provisions, then in addition to any other rights and remedies CITY may have, CONSULTANT shall reimburse CITY, within ten (10) days after demand, for any and all costs and expenses -5- 4851- 9718 -06970 i dr. WnFnal incurred by CITY in order to complete the tasks constituting the scope of work as described in this Agreement, to the extent such costs and expenses exceed the amounts CITY would have been obligated to pay CONSULTANT for the performance of that task pursuant to this Agreement. Termination for Failure to Make Agreed -Upon Payments Should CITY fail to pay CONSULTANT all or any part of the compensation set forth in Article 4 of this Agreement on the date due, then if and only if such nonpayment constitutes a default under this Agreement, CONSULTANT, at the CONSULTANT'S option, may terminate this Agreement if such default is not remedied by CITY within thirty (30) days after demand for such payment is given by CONSULTANT to CITY. Transition After Termination Upon termination, CONSULTANT shall immediately stop work, unless cessation could potentially cause any damage or harm to person or property, in which case CONSULTANT shall cease such work as soon as it is safe to do so. CONSULTANT shall incur no further expenses in connection with this Agreement. CONSULTANT shall promptly deliver to CITY all work done toward completion of its services, and shall act in such a manner as to facilitate any new CONSULTANT'S assumption of duties. ARTICLE 8. GENERAL PROVISIONS Notices Any notice to be given hereunder by either party to the other may be effected either by personal delivery in writing or by mail, registered or certified, postage prepaid with return receipt requested. Mailed notices shall be addressed to a party at the address appearing below such party's signature below, but each party may change the address by written notice in accordance with this paragraph. Notices delivered personally will be deemed delivered as of actual receipt; mailed notices will be deemed delivered as of three (3) days after mailing. Entire Agreement of the Parties This Agreement supersedes any and all prior agreements, either oral or written, between the parties hereto with respect to the rendering of services by CONSULTANT for CITY and contains all the covenants and agreements between the parties with respect to the rendering of such services in any manner whatsoever. Each party to this Agreement acknowledges that no representations, inducements, promises or agreements, orally or otherwise, have been made by any party, or anyone acting on behalf of any party, which are not embodied herein, and that no other agreement, statement or promise not contained in this Agreement shall be valid or binding. Any modification of this Agreement will be effective only if it is in writing signed by both parties. Partial Invalidity -6- 4851- 9718 -0697v1 If any provision in this Agreement is held by a court of competent jurisdiction to be invalid, void or unenforceable, the remaining provisions will nevertheless continue in full force without being impaired or invalidated in any way. Americans With Disabilities Act of 1990 Throughout the term of this Agreement, the CONSULTANT shall comply fully with all applicable provisions of the Americans With Disabilities Act of 1990 ( "the Act ") in its current form and as it may be amended from time to time. The Contractor shall also require such compliance of all subcontractors performing work under this Agreement, subject to the prohibition against assignment and subcontracting contained in Article 5 above. The CONSULTANT shall defend with counsel acceptable to CITY, indemnify and hold harmless the CITY OF GILROY, its officers, employees, agents and representatives from and against all suits, claims, demands, damages, costs, causes of action, losses, liabilities, expenses and fees, including without limitation attorneys' fees, that may arise out of any violations of the Act by the CONSULTANT, its subcontractors, or the officers, employees, agents or representatives of either. Compliance With Laws The CONSULTANT shall keep itself informed of all State and National laws and all municipal ordinances and regulations of the CITY which in any manner affect those engaged or employed in the work, or the materials used in the work, or which in any way affect the conduct of the work, and of all such orders and decrees of bodies or tribunals having any jurisdiction or authority over the same. Without limiting the foregoing, CONSULTANT agrees to observe the provisions of the Municipal Code of the CITY OF GILROY, obligating every contractor or subcontractor under a contract or subcontract to the CITY OF GILROY for public works or for goods or services to refrain from discriminatory employment or subcontracting practices on the basis of the race, color, sex, religious creed, national origin or ancestry of any employee, applicant for employment, or any potential subcontractor. Attorneys' Fees If any action at law or in equity, including an action for declaratory relief, is brought to enforce or interpret the provisions of this Agreement, the prevailing party will be entitled to reasonable attorneys' fees, which may be set by the court in the same action or in a separate action brought for that purpose, in addition to any other relief to which that party may be entitled. Governing Law and Venue This Agreement shall be governed by and construed in accordance with the laws of the State of California without regard to the conflict of laws or provisions of any jurisdiction. The -7- 4851-9718-06970 i ar.1na7nFnwA exclusive jurisdiction and venue with respect to any and all disputes arising hereunder shall be in state and federal courts located in Santa Clara County, California. Executed at Gilroy, California, on the date and year first above written. CONSULTANT: NBS By: c (Print Name) Address for Notices: 32605 Temecula Parkway, Ste 100 Temecula, CA 92592 Social Security or Taxpayer Identification Number: 33- 0712512 By: WAq F—k- i S Title: C4 ei--r- -8- 4851 - 9718- 0697vl I Arn47nrnA.,A CITY: CITY OF GILROY By:_ J3 (61 i . Fo Ws_ (Print Name) Address for Notices: 7351 Rosanna Street Gilroy, CA 95020 Attn: City Administrator Approved as to Form: -,�:71 City Att rney EXHIBIT "A" I. SCOPE OF SERVICES II. NOTICE TO PROCEED /COMPLETION OF SERVICE A. NOTICE TO PROCEED CONSULTANT shall commence services upon delivery to CONSULTANT of written Notice to Proceed. B. COMPLETION OF SERVICES When CITY determines that CONSULTANT has satisfactorily completed all of the services defined under this Agreement, CITY shall give CONSULTANT written Notice of Final Acceptance, and CONSULTANT shall not incur any further costs hereunder. CONSULTANT may request this determination of completion when, in its opinion, it has satisfactorily completed all of the services under this Agreement, and if so requested, CITY shall make this determination within two (2) weeks of such request, or if CITY determines that CONSULTANT has not satisfactorily completed all of such services, CITY shall so inform CONSULTANT within this two (2) week period. III. SCHEDULE IV. DIRECT EXPENSES Direct expenses are charges and fees not included in the Scope of Services described above. CITY shall be obligated to pay only for those direct expenses which have been previously approved in writing by CITY. CONSULTANT shall obtain written approval from CITY prior to incurring or billing of direct expenses. Copies of pertinent financial records, including invoices, will be included with the submission of billing(s) for all direct expenses. III. GENERAL PROVISIONS A. STANDARD OF WORKMANSHIP CONSULTANT represents and warrants that it has the qualifications, skills and licenses necessary to perform the services, and its duties and obligations, expressed and implied, contained herein, and CITY expressly relies upon CONSULTANT'S representations and -9- 4851- 9718 -06970 warranties regarding its skills, qualifications and licenses. CONSULTANT shall perform such services and duties in conformance to and consistent with the standards generally recognized as being employed by professionals in the same discipline in the State of California. B. RESPONSIBILITY OF CONSULTANT CONSULTANT shall be responsible for the professional quality, technical accuracy, and the coordination of the services furnished by it under this Agreement. The CITY'S review, acceptance or payment for any of the services required under this Agreement shall not be construed to operate as a waiver of any rights under this Agreement or of any cause of action arising out of the performance of this Agreement, and CONSULTANT shall be and remain liable to CITY in accordance with applicable law for all damages to CITY caused by CONSULTANT'S negligent performance of any of the services furnished under this Agreement. C. RIGHT OF CITY TO INSPECT RECORDS OF CONSULTANT CITY, through its authorized employees, representatives or agents, shall have the right, at any and all reasonable times, to audit the books and records (including, but not limited to, invoices, vouchers, canceled checks, time cards, etc.) of CONSULTANT for the purpose of verifying any and all charges made by CONSULTANT in connection with this Agreement. CONSULTANT shall maintain for a minimum period of three (3) years (from the date of final payment to CONSULTANT), or for any longer period required by law, sufficient books and records in accordance with standard accounting practices to establish the correctness of all charges submitted to CITY by CONSULTANT, all of which shall be made available to CITY at the CITY's offices within five (5) business days after CITY'S request. D. NO PLEDGING OF CITY'S CREDIT. Under no circumstances shall CONSULTANT have the authority or power to pledge the credit of CITY or incur any obligation in the name of CITY. E. OWNERSHIP OF MATERIAL. All material (including information developed on computer(s)) prepared (or caused to be prepared) under this Agreement shall be the property of CITY. F. NO THIRD PARTY BENEFICIARY. This Agreement shall not be construed or deemed to be an agreement for the benefit of any third party or parties, and no third party or parties shall have any claim or right of action hereunder for any cause whatsoever. G. WAIVER. CONSULTANT agrees that waiver by CITY of any one or more of the conditions of performance under this Agreement shall not be construed as waiver(s) of any other condition of performance under this Agreement. -10- 4851- 9718 -06970 H. AMENDMENTS. No alterations or changes to the terms of this Agreement shall be valid unless made in writing and signed by both parties hereto. I. CONFLICT OF INTEREST. CONSULTANT certifies that to the best of its knowledge, no CITY employee or office of any public agency interested in this Agreement has any pecuniary interest in the business of CONSULTANT and that no person associated with CONSULTANT has any interest that would constitute a conflict of interest in any manner or degree as to the execution or performance of this Agreement. J. CAPTIONS. The captions of the various sections, paragraphs and subparagraphs of this Agreement are for convenience only and shall not be considered nor referred to for resolving questions or interpretation. -11- 4851- 9718- 0697v1 I ArAna7nfmi EXHIBIT "B" PAYMENT SCHEDULE -12- 4851- 9718 -0697v1 i Arkn47nRnR. EXHIBIT A CONSULTANT SCOPE OF SERVICES Continuing Disclosure In accordance with the Continuing Disclosure Certificate for each debt issue, Consultant will support with the annual disclosure filing requirements of the SEC Continuing Disclosure Rule 15c2 -12. Specifically, Consultant will perform the following: Document Collection. Consultant will collect the annual financial information and operating data that the Client has agreed to provide to the Electronic Municipal Market Access system (the "EMMA "). At the time of engagement of this service the Client determined the appropriate document is the Comprehensive Annual Financial Report. Annual Dissemination. Consultant will disseminate the Comprehensive Annual Financial Report to EMMA, and post to our website to allow public access free of charge. Significant Events. Consultant will prepare and Events ", as listed on the applicable Continuing required in each certificate. Action will commence occurrence of any of the events. disseminate a "Notice of Significant Disclosure Certificate, to EMMA, as upon notification by the Client of the QNBS 7 Gilroy_Continuing Disclosure-4-2-15 EXHIBIT B COMPENSATION FOR SERVICES Annual Disclosure ............................................... ............................... $250 per debt issue Significant Event Notification .............................. .........................hourly or $250 per event Dissemination Services Report Dissemination (per recipient) ................. ......... $25 ....... ............................... Significant Event Dissemination (per recipient) ................. ............................... $25 Posting to NBS website ...................................................... ............................... No charge Annual Fee Increases Cost of living increases may be applied to the services listed above on October 1 each year, beginning with October 1, 2015. The COLA would be the actual cost of living increase based on the U.S. Department of Labor, Bureau of Labor Statistics, Consumer Price Index for all urban consumers for the Northern California counties. Expenses Customary out -of- pocket expenses will be billed to the Client at actual cost to Consultant. These expenses may include, but not be limited to, mailing fulfillment, postage, reproduction, telephone, travel, meals and various third -party charges for data, maps, and recording fees. Additional Services The following table shows our current hourly rates. Additional services authorized by the Client but not included in the scope of services will be billed at this rate or the then applicable hourly rate. Title Director Hourly RaE= $ 205 Senior Consultant/Engineer 160 Consultant 140 Analyst 120 Clerical /Support 95 QNBS8 Gilroy_Coniinuing Disclosure-4-2-15 EXHIBIT C BOND ISSUES City of Gilroy 2009 General Obligation Bonds (Gilroy Community Library Project) 2010 General Obligation Bonds (Gilroy Community Library Project) 2010 Wastewater Revenue Refunding Bonds Gilrov Public Facilities Financina Authority Refunding Lease Revenue Bonds, Series 2010 • Refunding Lease Revenue Bonds, Series 2013 10 Gitroy_Contlnuing Disdosure�_ 4 -2 -15 NBSGOVE -01 PA3 ' 10a. ' CERTIFICATE OF LIABILITY INSURANCE °ATE`M 9/221/201201Y,"' 6 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE. HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER_._ IMPORTANT: If the certificate holder Is An ADDITIONAL INSURED, the policy(ies) must be endorsed. WSUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER (858) 869-8300 Vanorsdale Insurance Services 6165 Greenwich Drive, Suite 200 San Diego, CA 92122 ,NAME: Janet Darby PHONE FAX A/c No. E •858- 869 -8300 IAIC NO 858 -869 -8301 DDRE ASS: INSURERS AFFORDING COVERAGE. NAIC # INSURER A: Hanover Insurance Company 22292 INSURED NBS Government Finance Group 32605 Temecula Parkway, Suite 100 & 101 Temecula, CA 92592 INSURERB:Allmerica Financial Benefit, 41840 INSURERC:Gemini Insurance Company 10833 INSURER D: $ 2,00000 INSURER E: PREMISES Ea occurrence INSURER F COVERAGES CERTIFICATE NUMBER: RPikkihN 141imRltQ- THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE ,POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN,MAY HAVE BEEN REDUCED BY CLAIMS. IILTR TYPE OF INSURANCE ADD 269JD R J= POLICY NUMBER POLICY PAID MM/uDDY EXP LIMITS A X COMMERCIAL GENERAL LIABILITY -XI CLAIMS -MADE OCCUR OH3A43196302 9/24/2016 9/24/2017 EACH OCCURRENCE $ 2,00000 PREMISES Ea occurrence $ 2,000,000 MED EXP (Any one person) $ 10,00 PERSONAL & ADV INJURY $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: X POLICY JECT F LOC GENERAL AGGREGATE $ 4,000,000 PRODUCTS - COMP /OP AGG $ 4,000,00 $ OTHER: B AUTOMOBILE LIABILITY ANY AUTO AW3A42745802 9/24/2016 9/24/2017 COMBINED SINGLE LIMIT Eaacddent $ 1,000,000 X BODILY INJURY (Per person) $ ALL OWNED SCHEDULED AUTOS AUTOS NON -OWNED HIREDAUTOS AUTOS BODILY INJURY (Per ( ) $ PROPERTY DAMAGE Per accident $ $ X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 1,000,000 AGGREGATE $ A EXCESS LIAB CLAIMS -MADE OH3A43196302 9/2412016 9124/2017 DED I I RETENTION $ $ A WORKERS COMPENSATION AND EMPLOYERS' LI ABILI T ANY PROPRIETOR/PARTNER/EXECUTIVE Y/N OFFICER/MEMBER EXCLUDED? ( If Mandatory yes, describe under DESCRIPTION IPTI OF O DESCRIPTION.OF OPERATIONS below N / A H3A42745703 9/24/2016 9124/2017 PER OTH- X STATUTE ER E. L. EACH ACCIDENT $ 1,000,000 E:L. DISEASE_- EA EMPLOYE $ 1,000,00 E.L. DISEASE - POLICY LIMIT �$ 1,000,000 C Professional Liability VCPLO64726 9/24/2016 9/2412017 Each Wrongful Act $2,000,00 C Professional Liability VCPL064726 9/2412016 912412017 Annual Aggregate $2,000,00 DESCRIPTION OF OPERATIONS /LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space is required) See attached page. City of Gilroy Attn: Mr. Raymond Chin 7351 Rosanna Street Gilroy, CA 95020- SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. %UTHORIZED REPRESENTATIVE ,C---- - °_ __r� `- c- c�".�'�>'"- l'�_._ � - -> •�'� —_ Gam_ ��•_� ©1988 -2014 ACORD CORPORATION. All rights reserved. AGUKU Z5 (ZO14101) The ACORD name and logo are registered marks of ACORD NBSGOVE -01 PA3 PAGE 1 OF 1 DESCRIPTION OF OPERATIONS -. NBS Government Finance Group City of Gilroy 32605 Temecula Parkway, Suite 100 & 101 Attn: Mr. Raymond Chin Temecula, CA 92592 7351 Rosanna Street Gilroy, CA. 95020- Proof of Insurance Blanket forms apply when required by written contract: GENERAL LIABILITY: Additional Insured - Special Broadening Endt: 391 -1006 06 09 Additional Insured - Completed Operations: 391 -1602 1211 Primary & Non - Contributory: 391-133106 09 Waiver of Subrogation: BP0497 07 02 Additional Insured: 461- 0478 1212 Primary & Non - Contributory: 461 -0478 12 12 Waiver of Subrogation: 461 -0500 11 13 WORKERS' COMPENSATION: Waiver of Subrogation: WC040306 4 -84 *CERTIFICATE ISSUED DUE TO POLICY RENEWAL* POLICY #OH3 A43196302 BUSINESSOWNERS LIABILITY SPECIAL BROADENING ENDORSEMENT THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies insurance provided under the following: BUSINESSOWNERS COVERAGE FORM SUMMARY OF COVERAGES Limits Page 1. Additional Insured by Contract, Agreement or Permit 1 2. Additional Insured - Broad Form Vendors 2 3. Alienated Premises 2 4. Bodily Injury Redefined 2 5. Broad form Property Damage - Borrowed Equipment, Customers 2 Goods and Use of Elevators 6.. Incidental Malpractice (Employed Nurses, EMT's and Paramedics) 3 7. Personal and Advertising Injury - Broad Form 3 8. Product Recall Expense $25,000 Occurrence $50,000 Aggregate 3 9. Unintentional Failure to Disclose Hazards 5 10. Unintentional Failure to Notify. 5 This endorsement amends coverages provided under the Businessowners Coverage Form through now. coverages and broader coverage grants. This coverage is subject to the provisions applicable to the Businessowners Coverage Form, except as provided below. 1. Additional Insured by Contract, Agreement or Permit Under SECTION II - LIABILITY, C. Who Is An Insured, Paragraph 4. is added as follows: a. Any person or organization for whom you are performing operations when you and such person or organization have agreed in writing in a contract, agreement or permit that such person or organization be added as an additional insured on your policy. Such person or organization is an additional . insured only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by: (1) Your acts or omissions: or (2) The acts or omissions of those acting on your behalf, but only with respect to: (3) "Your work" for the additional insured(s) at the location designated in the contract, agreement or permit; or (4) Premises you own, rent, lease, control or occupy. This insurance applies on a primary, basis if that is required by the written contract, agreement or permit. b. This provision does not apply: (1) Unless the written contract or written agreement has been executed or permit has been issued prior to the "bodily injury ", "property damage" or "personal and advertising injury" ; (2) To any person or organization included as an insured by an endorsement issued by us and made part of this Policy; (3) To any person or organization included as an insured under Item 1.a.2. of this endorsement; (4) To any lessor of equipment: (a) After the equipment lease expires; or (b) If the "bodily injury", "property damage' or "personal and advertising injury" arises out of the sole negligence of the lessor; 391.1006 06 09 Includes copyrighted material of Insurance Services Office, Inc. Page 11 of 5 (5) To any: . (a) Owners or _ other interests from whom land has been leased which takes place after the lease for that land expires; or (b) Managers or lessors of premises if: (i) The occurrence takes place after you cease to be a tenant in that premises; or (ii) The "bodily injury ", "property damage" or "personal and advertising injury" arises out of structural alterations, new construction or demolition operations performed by or on behalf of the manager or lessor; or (6) To "bodily injury", "property damage" or 'Personal and advertising injury" arising out of the rendering of or the failure to render any professional services. c. Additional insured coverage provided by this provision will not be broader than coverage provided to any other insured. d. All other insuring agreements, exclusions, and conditions of the policy apply. 2. Additional Insured Broad Form Vendors Under SECTION 11 - LIABILITY, C. Who Is An Insured, paragraph 5. is added as follows: 5. Any person or organization with whom you agreed, because of a written contract or written agreement to provide insurance, but only with respect to "bodily injury" or "property damage" arising out of "your products" which are distributed or sold in the regular course of the vendor's business. The insurance afforded the vendor does not apply to: a. "Bodily injury" or "property damage" for which the vendor is obligated to pay damages by reason of the assumption of liability in a contract or agreement. This exclusion does not apply to liability for damages that the vendor would have in the absence of the contract or agreement; b. Any express warranty unauthorized by you; c. Any physical or chemical change in the product made intentionally by the vendor; d. Repackaging, unless unpacked solely for the purpose of inspection, lnsur�rstg l,rnrtP. 011 3;A413.1,963 1001554 demonstration, testing, or the substitution of parts under instruction from the manufacturer, and then repackaged in the original container; e. Any failure to make such inspection, adjustments_, tests or servicing as the vendor has agreed to make or normally undertakes to make in the usual course of business in connection with the distribution or sale of the product; f. Demonstration, 'installation, servicing or repair operations, except such operations performed at the vendor's premises in connection with the sale of the product; g. Products which, after distribution or sale by you, have been labeled or relabeled or used as a container, part or ingredient of any thing or substance by or for the vendor, or h. "Bodily injury" or "property damage" arising out of the sole negligence of the vendor for its own acts or omissions or those of its employees or anyone else acting on its behalf. However, this exclusion does not apply to: (1) The exceptions contained in paragraphs 5.d. or 51; or (2) Such inspections, adjustments, test or servicing as the vendor has agreed to make or normally undertakes to make in the usual course of business, in connection with the distribution or sale of the products. This insurance does not apply to any insured person or organization, from whom you have acquired such products, or any ingredient, part or container, entering into. accompanying or containing such products. 3. Alienated Premises Under SECTION It - LIABILITY, B. Exclusions, paragraph 1.k.(2) is replaced in. its entirety with the following: (2) Premises you sell, give away or abandon, if the "property. damage" arises out of any part of those premises and occurred . from hazards that were known by you, or should have reasonably been known by you, at the time the property was transferred or abandoned. 4. Bodily Injury Redefined Under SECTION It - LIABILITY, F. Liability and Medical Expenses Definitions, definition 4, is replaced in its entirety by the following: 391 -1006 06 09 Includes copyrighted material of Insurance Services Office, Inc. Page 2 of 5 4. "Bodily injury" means bodily injury, disability, sickness or disease sustained by a person, including death resulting from any of these at any time. "Bodily .lniury" 'includes mental anguish or other Mental iniury resulting.'fror ":bodily injury" 5. Broad Form Property Damage - Borrowed Equipment, Customers Goods, Use of Elevators a. Under SECTION 11 - LIABILITY, B. Exclusions, paragraph 1.k., the following is added: Paragraph (4) does not apply to "property damage" to borrowed equipment while at a jobsite and not being used to perform operations. Paragraph (3), (4) and (6) do not apply to "property damage" to "customers goods" while on your premises nor to the use of elevators. b. Under SECTION II - LIABILITY, F. Liability and Medical Expenses Definitions, the following additional definition is added: "Customers goods" means property of your customer on your premises for the purpose of being:. a. Worked on; or b. Used in your manufacturing process. c. The insurance afforded under this provision is excess over any other valid and collectible property insurance (including deductible) available to the insured whether primary, excess, contingent or on any other basis_ 6. Incidental Malpractice - Employed Nurses, EMT's and Paramedics Under SECTION II - LIABILITY, C. Who Is An Insured, paragraph 2.a.(1)(d) does not apply to a nurse, emergency medical technician or paramedic employed by you if you are not engaged In the business or occupation of providing medical, paramedical, surgical, dental, x -ray or nursing services. 7. Personal and Advertising Injury - Broad Form Under SECTION II - LIABILITY, F. Liability and Medical Expenses Definitions, definition 15, "Personal and Advertising Injury ", paragraph h. is added as follows: h. Discrimination or humiliation (unless insurance thereof is prohibited by law) that results in injury to the feelings or reputation of a natural person, but only if such discrimination or humiliation is: (1) Not done intentionally by or at the direction of: (a) The insured; or (b) Any officer of the corporation, director, stockholder, partner or member of the Insured; and (2) Not directly or indirectly related to an "employee ", nor to the employment, prospective employment or termination of any person or persons by an insured. 8. Product Recall Expense a. cinder SECTION II - LIABILITY, B. Exclusions, Paragraph 1. o. is replaced in its entirety by the following: o. Recall of Products, Work or Impaired Property Damages claimed for any loss, cost .or expense incurred by you or others for the loss of use, withdrawal, recall, inspection, repair, replacement, adjustment, removal or disposal of. (1) "Your product "; (2) "Your work "; or (3) "Impaired property "; If. such product, work or property is withdrawn or recalled from the market or from use by any person or organization because of a known or suspected defect, deficiency, inadequacy or dangerous condition in it, but this exclusion does not apply to "product recall expenses that you incur for the "covered recall" of "your product ". The exception to the exclusion does not apply to "product recall expenses" resulting from: (1) Failure of any products to accomplish their intended purpose; (2) Breach of warranties of fitness, quality, durability or performance; (3) Loss of customer approval, or any cost incurred to regain customer approval; (4) Redistribution or replacement of your product" which has been recalled by like products or substitutes; (5) Caprice or whim of the insured; (6) A condition likely to cause loss of which any insured knew or had reason to know at the inception of this insurance; (7) Asbestos, including loss, damage or clean up resulting from asbestos or asbestos containing materials; or 381 -1006 06 09 Includes copyrighted material of Insurance Services office. Inc_ Page 3 of 5 (8) Recall of "your products" that have no known or .suspected defect solely because a known or suspected defect in another of your products" has been found. b. Under SECTION It - LIABILITY, C. Who Is An Insured, paragraph 4.c. is added as follows: c. "Bodily injury" or "property damage" do not apply to "product recall expense" arising out of any withdrawal or recall that occurred before you acquired or formed the organization. c. Under SECTION 11 - LIABILITY, E. Liability and Medical Expense General Condifrons, 2. Duties in the Event of Occurrence, Offense, Claim or Suit. paragraph e. is added as follows: e. You must see to it that the following are done in the event of an actual or anticipated "covered recall" that may result in "product recall expense ": (1) Give us prompt notice of any discovery or notification that "your product" must be withdrawn or recalled. Include a description of "your product" and the reason for the withdrawal or recall; (2) Cease any further release, shipment, consignment or any other method of distribution of like or similar products until it has been determined that all such products are free from defects that could be a cause of loss under this Insurance. d. Under SECTION it - LIABILITY, F. Liability and Medical Expenses Definitions, the following additional definitions are added: "Covered recall" means a recall made necessary because you or a government body has determined that a known or suspected defect, deficiency, inadequacy, or dangerous condition in "your product" has resulted or will result in "bodily injury" or "property damage ". "Product recall expense(s)" means: a. Necessary and reasonable expenses for. (1) Communications, including radio or television announcements or Han ' (niur3�)ce! Grtlup" OH3 A431963 1901554 printed advertisements including stationary, envelopes and postage; (2) Shipping the recalled products from any purchaser, distributor or user to the place or places designated by you; (3) Remuneration paid to your regular "employees" for necessary overtime; (4) Hiring additional persons, other than your regular "employees "; (5) Expenses incurred by "employees" including transportation and accommodations; (6) Expenses to rent additional warehouse or storage space; (7) Disposal of ".your product", but only to the extent that specific methods of destruction other than those employed for trash discarding or disposal are required to avoid "bodily injury" or "property damage" as a result of such disposal, you incur exclusively for the purpose of recalling "your product "; and b. Your lost profit resulting from such "covered recall ". e. Under SECTION If - LIABILITY, D. Liab6'te y and Medical Expenses Limns of Insurance, the following is added: 5. The Limits of Insurance and rules stated below fix the most that we will pay under this Product Recall Expense Coverage. (1) The Aggregate Limit is the most that we will reimburse you for the sum of all °product recall expenses" incurred for all "product recall expenses" initiated during the policy period. (2) The Occurrence Limit shown on the Summary of Coverages is the most we will pay in connection with any one defect or deficiency. (a) All "product recall expenses" in connection with substantially the same general harmful condition will be deemed to arise out of the same defect or deficiency and considered one "occurrence ". 391.1006 06 09 Includes copyrighted material of insurance Services Office, Inc. Page 4 of 5 (b) Any amount reimbursed for "product recall expenses" in connection with any one "occurrence" will reduce the amount of the Aggregate Limit available for reimbursement of "product recall expenses" in connection with any other defect or deficiency. (c) If the Aggregate Limit has been reduced by, reimbursement of "product recall expenses" to an amount that is less than the Occurrence Limit, the remaining Aggregate Limit is the most that will be available for reimbursement of "product recall expenses" in connection with any other defect or deficiency. 6. A deductible of $5W applies per each "Occurrence ". 9. Unintentional Failure to Disclose Hazards Under SECTION 11 - LIABILITY, E. Liability and Medical Expenses General Conditions, paragraph 6. Is added as follows. 6. Representations We will not disclaim coverage under this Coverage Form if you fail to disclose all hazards existing as of the inception date of the policy provided such failure is not intentional. 10. Unintentional Fa9ure to Notify Under SECTION II - LIABILITY, I" Liability and Medical Expenses General Conditions, 2. Duties In the Event of Occurrence, Offense, Claim or Suit, paragraph f. Is added as follows: f. Your rights afforded under this Coverage Form shall not be prejudiced if you fail to give us notice of an 'occurrence ". offense, claim or "suit ", solely due to your reasonable and ° documented belief that the "bodily injury" or "property damage" is not covered under this Policy. 391 -1006 06 09 Includes copyrighted material of Insurance Services Office, Inc. Page 5 of 5 POLICY #OH3 A43196302 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED -OWNERS, LESSEES OR CONTRACTORS - COMPLETED OPERATIONS This endorsement modifies insurance provided under the following: BUSINESSOWNERS COVERAGE rORM SCHEDULE Name Of Additional Insured Person(s) Or'Organlzation(s) Location And Description Of Completed Operations ANY PERSON OR ORGANIZATION WHEN REQUIR AS REQUIRED BY CONTRACT Information required to complete this Schedule, if not shown above, will be shown in the Declarations. The following is added to Paragraph C. Who Is An Insured In Section 11- Liability: Any person(s) or organization(s) shown in the Schedule is also an additional insured, but only with respect to liability for "bodily injury" or "property damage" caused, in whole or in part, by "your work' at the location designated and de- scribed in the Schedule of this endorsement per- formed for that additional insured and included in the "products - completed operations hazard ". 391-1602 12 11 Includes copyrighted material of Insurance Services Offices, Inc„ with its permission Page 1 of 1 POLICY #01-13 A43196302 OTHER INSURANCE - PIUMARY AND NON - CONTRIBUTORY (ADDITIONAL INSURED) ENDORSEMENT THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies Insurance provided under the following: BUSINESSOWNERS COVERAGE FORM The following is added to SECTION Ill - COMMON POLICY CONDITIONS: M. Other Insurance 1. Additional Insureds If you agree in a written contract, written agreement or permit that the insurance provided to any person or organization included as an Additional Insured under SECTION 11 LIABILITY, Part C - Who is An Insured, is primary and non - contributory, the following applies: If other valid and collectible insurance is available to the Additional Insured for a loss we cover under SECTION II - LIABILITY, Part A. Coverages. Paragraph 1., Business Liability our obligations are limited as fokws: a. Primary Insurance This insurance is primary to other insurance that is available to the Additional Insured which covers the Additional Insured as a Named Insured. We will not seek contribution from any other insurance available to the Additional Insured except: (1) For the sole negligence of the Additional Insured; (2) When the Additional Insured is an Additional Insured under another primary liability policy; or (3) When b.(2) below applies. If this insurance is primary, our obligations are not affected unless any of the other insurance is also primary. Then, we will share with all that other insurance by the method described in b.(3) below. b. Excess Insurance This insurance is excess over: (1) Any of the other insurance, whether primary, excess, contingent or on any other basis: (b) That is Fire insurance for premises rented to the Additional Insured or temporarily occupied by the Additional Insured with permission of the owner; (c) That is insurance purchased by the Additional Insured to cover the Additional Insured's liability as a tenant for "property damage" to premises rented to the Additional Insured or temporarily occupied by the Additional Insured with permission of the owner; or (d) If the loss arises out of the maintenance or use of aircraft, "autos" or watercraft to the extent not subject to Exclusion g. of SECTION II - LIABILITY, Part A. Coverages, 1. Business Liability. When this insurance is excess, we will have no duty under SECTION II - UABILITY, Part A. Coverages, 1. Business Liability to defend the insured against any "suit" if any other insurer has a duty to defend the Insured against that "suit ". If no other insurer defends, we will undertake to do so, but we will be entitled to the insured's rights against all those other insurers. When this insurance is excess over other insurance, we will pay only our share of the amount of the loss, if any, that exceeds the sum of: (2) The total amount that all such other insurance would pay for the loss in the absence of this insurance; and (3) The total of all deductible and self - insured amounts under all that other insurance. (a) That is Fire, Extended Coverage; We will share the remaining loss, if any, Builder's Risk, Installation Risk with any other insurance that is not or similar coverage for "your work "; 391 -1331 06 09 Includes copyrighted malarial of Insurance Services Offices, Inc., with its permission Page 1 of 2 IFk a�` nq V �r lnsisrance GrotiP- 01-13A431963 1001554 described in this Excess Insurance provision and was not bought specifically to apply in excess of the Limits of Insurance shown in the Declarations of this Coverage Part. c. Method Of Sharing If all of the other insurance permits contribution by equal shares, we will follow this method also. Under this approach each insurer contributes equal amounts until it has paid its applicable limit of insurance: or none of the loss remains, whichever comes first. If any of the other insurance does not permit contribution by equal shares, we will contribute by limits. Under this method, each insurer's share is based on the ratio of its applicable limit of insurance to the total applicable limits of insurance of all insurers. 391 -1331 06 09 Includes copyrighted rnaterial of Insurance Services Offices, Inc., with its permission ?age 2 of 2 POLICY #01-13 A43196302 F.. H'an�u�r Insuranc.c {�raun. OH3 A431963 1001554 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US This endorsement modifies insurance provided under the following: BUSINESSOWNERS COVERAGE FORM SCHEDULE" Name Of Person Or Organization: ANY PERSON OR ORGANIZATION WHEN REQUIRED BY A WRITTEN CONTRA CT, WRITTEN AGREEMENT OF PERMIT" * Information required to complete this Schedule, if not shown on this endorsement, will be shown in the Paragraph K. Transfer Of Rights Of Recovery Against others To Us in Section III - Common Pol- icy Conditions is amended by the addition of the following: We waive any right of recovery we may have against the person or organization shown in the Schedule above because of payments we make for injury or damage arising out of your ongoing op- erations or "your work" done under a contract with that person or organization and included in the "products- completed operations hazard ". This waiver applies only to the person or organization shown in the Schedule above. BP 04 97 07 02 Copyright, ISO Properties, Inc., 2001 Page 1 of 1 HAnover POLICY #AW3 A42745802 Insurance Group. AW3A427458 1001554 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BLANKET ADDITIONAL INSURED - PRIMARY AND NON - CONTRIBUTORY This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE PART A. The following. is added to SECTION II - LIABILITY COVERAGE, Paragraph A.1. Who is An Insured: Additional Insured if Required by Contract If you agree in a written contract, written agreement or written permit that a person or organization be added as an additional "insured" under this Coverage Part, such person or organization is an "insured.. "; but only to the extent that such person or organization qualifies as an "insured" under paragraph A.1.c. of this Section. If you agree in a written contract, written agreement or written permit that a person or organization be , as an additional "insured" under tis Coverage Part, the most we will pay on behalf of such additional "Insured" is the lesser of: (1) The Limits of Insurance for liability coverage specified in the written contract, written agreement or written permit; or (2) The Limits of Insurance for Liability Coverage shown in the Declarations applicable to this Coverage Part. Such amount shall be part of and not in addition to the Limits of Insurance shown in the Declarations applicable to this Coverage Part. Regardless of the number of covered autos ", "insureds ", premiums paid, claims made or vehicles involved in the "accident ", the most we will pay for the total of all damages and "covered pollution cost or expense" combined resulting from any one "accident" is the Limit of Insurance for Liability Coverage shown in the Declarations. B. The following is added_ - to SECTION IV - BUSINESS AUTO CONDITIONS, Paragraph B. General Conditions, subparagraph 5. Other Insurance: Primary and Non - Contributory If you agree in a written contract, written agreement or written permit that the insurance provided to a person or organization who qualifies as an additional _ "insured" under SECTION II - UABIUTY dOVERAGE, Paragraph A.I. Who Is An Insured, , subparagraph Additional Insured if Required by Contract is primary and non- contributory, the following applies: The liability coverage provided by this Coverage Part is primary to any other insurance available to the additional "insured" as a Named Insured. We will not seek contribution' from any other insurance available to the additional "insured" except: (1) For the sole negligence of the additional "insured "; or (2) For negligence arising out of the ownership, maintenance or use of any "auto" not owned by the additional "insured" or by you, unless that "auto" is a "trailer" connected to an "auto" owned by the additional "insured" or by you; or (3) When. the tadditional "insured" is also an additional "insured" under another liability policy. C. This endorsement will apply only if the "accident" occurs: 1. During the policy period; 2. Subsequent to the execution of the written contract or written agreement or the issuance of the written permit; and 3. Prior to the expiration of the period of time that the written contract, written agreement or written. permit requires such insurance to be provided to the additional "insured ". D. Coverage provided to an additional "insured" will not be broader than coverage, provided to any other "insured" under this Coverage Part. ALL OTHER TERMS, CONDITIONS, AND EXCLUSIONS REMAIN UNCHANGED. 461 -0478 12 12 Includes copyrighted material of ISO Insurance Services Office, Inc., with its permission Page 1 of 1 POLICY #AW3A42745802 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. WAVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US (WAVER OF SUBROGATION) This endorsement modifies Insurance provided under the following: BUSINESS AUTO COVERAGE FORM BUSINESS AUTO PHYSICAL DAMAGE COVERAGE FORM GARAGE COVERAGE FORM MOTOR CARRIER COVERAGE FORM TRUCKERS COVERAGE FORM Insuran[e Grnup. AVV3A427458 1001554 With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by the endorsement. This endorsement changes the policy effective on the inception date of the policy unless another date is indicated below. Named Insured: NBS GOVERNMENT FINANCE GROUP Endorsement Effectiv2016 Names) Of Person(s) Or Organization(s): ANY PERSON OR ORGANIZATION WHEN REQUIRED BY A WRIT Information required to complete this Schedule, if not shown above. will be shown in the Declarations The Transfer Of Rights Of Recovery Against Others To Us Condition does not apply to the person(s) or organization(s) shown in the Schedule. but only to the extent that subrogation Is waived prior to the "accident" or the "loss" under a contract with that person or organization. 4611-05001113 Includes copyrighted material of Insurance Services Offtce, Inc., with its permission page 1 of 11 WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT -CALIFORNIA g payments fromianyon,e l fable. lbr an injury covered by this policy We will not enforce our We right �against the person. or organization named in the Sshedute::(This agreement ap`plles only to the- ekfent that you perform 9. p 9 work under a written.confract ".thaCrequiras you to obtain. this, agreement from us.) You must maintain payroll records accurately segregating the remuneration of your employees while engaged in the work described in the Schedule. The additional premium for this endorsement shall be 2 % of the California workers' compensation premium otherwise due on such remuneration. Schedule Person or Organization Job Description ONLY WHERE REQUIRED BY CONTRACT This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated.: (The information below is required only when this endorsement is issued subsequent to preparation of the policy.) Endorsement Effective 9/24/2016 Policy No. WH3A42745702 Endorsement No. Insured Premium $ NBS GOVERNMENT FINANCE GROUP Insurance CompanyTHS HANOVER INSURANCE COMPANY Countersigned By WC 04 03 06 (Ed. 04-84)